Nigrostriatal Imaging with Dopamine Transporter SPECT

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification for enrollments starting after May 9, 2023:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Nuclear Medicine Technology: 2.00
Procedures: 2.00
Other Imaging Procedures: 2.00

Registered Radiologist Assistant: 2.25
Safety: 0.25
Patient Safety, Radiation Protection, and Equipment Operation: 0.25
Procedures: 2.00
Neurological, Vascular, and Lymphatic Sections: 2.00

Outline

1. Introduction
2. Proof of Neurodegenerative PS
3. Early Diagnosis of Neurodegenerative PS
4. SWEDDS
   1. Assessment of Disease Progression
   2. Differential Diagnosis Between Neurodegenerative Types of PS
5. Proof of Symptomatic Parkinsonism
   1. Tremor Syndromes
   2. Vascular PS
   3. Drug-Induced PS
   4. Psychogenic PS
   5. Normal-Pressure Hydrocephalus
   6. Dopa-Responsive Dystonia (DRD
6. Differential Diagnosis of DLB
7. Selected Methodologic Considerations
8. Economic Considerations
9. Conclusion

Objectives

Upon completion of this course, students will:

1. know the anatomical structures targeted by ¹²³I-FP-CIT
2. discuss the various key functions that can be assessed with radioligant imaging
3. understand the physiologic process of DAT
4. identify the various reasons why the diagnosis of PD is clinically difficult
5. be familiar with the first structure affected by the loss of dopaminergic neurons
6. understand the distribution of ¹²³I-FP-CIT on a positive study
7. discuss what marked loss of striatal DAT binding indicates for a clinical patient
8. identify the threshold of nigrostriatal neuron loss where clinical symptoms appear
9. be familiar with SWEDD patients and why they are unique in ¹²³I-FP-CIT imaging
10. discuss the possible cause of SWEDD
11. discuss the differences between SWEDD patients and patients with classic PD
12. promote knowledge of disease progression for SWEDD patients as it compares to PS
13. be familiar with the differences between aPS and PD in terms of unique results of long term follow-up
14. understand the differences with annual rates of disease progression for early versus late stage patients
15. identify other imaging methods that can aid in the diagnosis of disease
16. understand the course of care when a study is reported as normal
17. understand unique characteristics of ET that make it different from other forms of tremor
18. understand the qualities and shortcomings of ¹²³I-FP-CIT in the differentiation of disease
19. know orthostatic tremor symptoms as they relate to other forms of tremor
20. know the symptoms associated with vascular PS
21. understand the effects of neuroleptic drugs and how they can induce parkinsonian symptoms
22. know gait disturbances that affect patients with Normal-Pressure Hydrocephalus
23. understand diseases that resemble PD in their symptoms
24. understand how ¹²³I-FP-CIT can be used to differentiate DLB from Alzheimer Disease
25. understand how ¹²³I-FP-CIT can be used to differentiate PS from Psychogenic PS
26. be familiar with the length of time needed for medication withholding prior to imaging
27. know the proper means of reducing radiation exposure to patients undergoing imaging
28. understand the appropriate action in the event of a hypersensitivity reaction
29. understand the required licensure for the handling and administration of ¹²³I-FP-CIT
30. be familiar with the manufacturer recommended wait time prior to the start of ¹²³I-FP-CIT imaging